| NPI | 1366064735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCUS WINTERS Hr Manager 180-021-0081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2020-05-08 |